Notes from the Long-Term Care Ombudsman

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Notes from the Long-Term Care Ombudsman


     Often times, residents express to us that their nursing home would be so much better if there were enough staff. Residents have openly expressed their concerns about the difficulties they have experienced in facilities that struggle with staffing. Often, residents who want to talk about staffing tell me the problem is simple: there are not enough nurses and aides to provide the help that they need. Additionally, Aides are sometimes expected to take on more responsibilities like housekeeping, dietary needs, and restorative therapy. This often limits the time that they can spend individually with residents.

     It is evident that higher levels of staffing lead to better care, however, the federal government does not require nursing homes to have a minimum number of staff on duty. As a result, there are nursing home residents who aren’t getting optimal care due to staffing concerns. Medical issues such as pressure ulcers (bedsores), infections, malnutrition, dehydration and injuries from falls can often times be prevented if a resident is receiving the quality care that they need. This is why sufficient staffing ratios is something critical to consider. There is research supporting sufficient staffing levels.

     Even the best nurses and nurse aides struggle to deliver quality care if there are understaffing issues. Since 2001, we have known that at a minimum a typical resident needs .75 hour with a registered nurse(RN), .55 hours with a licensed professional nurse (LPN), and 2.8 hours with a certified nurse aide (CNA) every day, totaling 4.1 hours of direct resident care per day.  This is the minimum necessary found to prevent unnecessary decline. Staffing requirements are at the discretion of individual states.  Kentucky currently does not require 4.1 hours of direct resident care per day. 

     Data about staff hours is now being collected by the federal government from facility payroll records. In order to provide the public with the relevant information on nursing home staffing rates, the Long-Term Care Community Coalition Nursing Home Information &Data Page has searchable and downloadable files on every licensed nursing home in the country.

     If you or a loved one are experiencing problems with care and services related to staffing issues, please contact the LTC Ombudsman Program via This email address is being protected from spambots. You need JavaScript enabled to view it.or at 859-283-8185.

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Northern Kentucky Area Development District

22 Spiral Drive
Florence, KY 41042
P: 859.283.1885
F: 859.283.8178
TDD: 711
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